Sinus Infection or Pseudomonas

@jcwest211 These are signs of an exacerbation - it doesn't really matter whether sinus or pseudomonas. It's time to contact your doctor before you have to wait through the holiday weekend and potentially end up in the ER.

This is a good reminder - anyone with a chronic lung disease who is susceptible to infections should work out an "emergency plan" with their pulmonologist.
The plan should include whether/when to "double up" on nebs and airway clearance, when to call them, and when to be seen immediately if your doc is not available.
Having a plan in place has kept me out of the ER, where unfamiliar docs nod their heads like they are agreeing with you, and then put forth an incorrect treatment.

Thanks for the quick reply, Sue! My pulmonologist is out of the country. I have contacted the office through My Chart but no reply. My primary care doctor put me on Augmentin in the event it is a sinus infection. I also have budesonide/fomoterol inhaler which I am using. I also have increased the airway clearance and nebulizer.

Those would be the first steps my pulmonologist would probably take. Have you had pseudomonas before?
And di your pulmonologist leave someone covering for them? When mine was on surgery leave, someone else was available to take questions, but I had to contact the office by phone to get their attention.

I am calling today to see if there is another doctor covering for him. I have never had pseudomonas. In the meantime, the Augmentin is already helping. The sweet smell I was experiencing is gone and the sinus pressure is also gone. I think this is a sinus infection.
However, I am still continuing the airway clearance and the budesonide/fomoterol inhaler twice a day.

ReRe. Another option which I used once since whenever I get sick it’s holiday or weekend, is to call your doctors office but ask for a pulmonology doctor on call. If he is in the same system he is able to look at your history and prescribe the right meds.

If you could luck into an ENT appt today, they could scope and get a culture of the sinus drainage. You can also try the NeilMed sinus rinse systems. They really help the sinuses. The silicone ones are are better because they can be boiled, but I usually have to order them. Good luck.

Thank you @pacathy!

Hi, Sue, i am in Canada, and my pulmonologist is hard to reach. I have bronch and ntm and have never had an exacerbation. I do worry about ending up in the ER with docs who don't have a clue about these conditions. I will raise the issue with my pulmo on my next visit. In the meantime do you have any suggestions about exacerbations and dodging ER lack of knowledge? I am using an Aerobika and have no other meds or treatment. My shortness of breath is getting worse.

When was the last time you had a sputum culture or CT of your lungs?

I have a number of Canadian friends and understand some of the difficulty you have getting to see specialists - is there any way to see yours soon?

I can usually get a phone appointment with the pulmo fairly quickly. CT in December 2024 showed worsening bronchiectasis. Waiting to be evaluated for cardio issues. Bronchoscopy in February 2025 revealed m abscessus subsp abscessus. Not treating while waiting for cardio appointment probably in August. Had some air hunger yesterday. Scary!